Does the hepatocellular phase of gadobenate dimeglumine help to differentiate hepatocellular carcinoma in cirrhotic patients according to histological grade?

Tahir, Bilal; Ramaswamy, R.; Bertrand, Kimberly A.; Mhapsekar, Rishi; Akisik, Fatih; Saxena, Romil

doi:10.1016/j.crad.2011.03.021

Cited by 11 publications

(4 citation statements)

References 38 publications

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“…Therefore, many efforts have focused on the non-invasive evaluation of HCC differentiation grade using radiological findings. Recent technique advances in magnetic resonance imaging (MRI) have enabled the evaluation of tumor histological grade through tumor vascularity by dynamic contrast enhanced MRI (DCE-MRI) [ 14 – 16 ], tumor cellularity by diffusion weighted imaging (DWI) [ 14 , 17 – 27 ] and the hepatocyte function by hepatocyte-specific agents [ 28 – 31 ]. Among them, DWI showed the most promising application.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Evaluation of the Histological Grade of Hepatocellular Carcinoma with Diffusion-Weighted Imaging: A Meta-Analysis

Chen

Liu

et al. 2015

PLoS ONE

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ObjectiveTo evaluate the diagnostic performance of diffusion-weighted imaging (DWI) in the preoperative prediction of the histological grade of hepatocellular carcinoma (HCC).Materials and MethodsA comprehensive literature search was performed in several authoritative databases to identify relevant articles. QUADAS-2 was used to assess the quality of included studies. Data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR). Summary receiver operating characteristic (SROC) curves were derived and areas under the SROC curve (AUC) were computed to indicate the diagnostic accuracy. Heterogeneity test, meta-regression analysis and sensitivity analysis were performed to identify factors and studies contributed to the heterogeneity.ResultsA total of 11 studies with 912 HCCs were included in this meta-analysis. The pooled sensitivity, specificity, PLR and NLR with corresponding 95% confidence intervals (CI) were 0.54(0.47–0.61), 0.90(0.87–0.93), 4.88(2.99–7.97) and 0.46(0.27–0.77) for the prediction of well-differentiated HCC (w-HCC), 0.84(0.78–0.89), 0.48(0.43–0.52), 2.29(1.43–3.69) and 0.30(0.22–0.41) for the prediction of poorly-differentiated HCC (p-HCC). The AUC were 0.9311 and 0.8513 in predicting w-HCC and p-HCC, respectively. Results were further evaluated according to the method of image interpretation. Significant heterogeneity was observed.ConclusionDWI had excellent and moderately high diagnostic accuracy for the detection of w-HCC and p-HCC, respectively. Nonetheless, further studies in larger populations and an optimized image acquisition and interpretation are required before DWI-derived parameters can be used as a useful image biomarker for the prediction of the histological grade of HCC.

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Section: Introductionmentioning

confidence: 99%

Preoperative Evaluation of the Histological Grade of Hepatocellular Carcinoma with Diffusion-Weighted Imaging: A Meta-Analysis

Chen

Liu

et al. 2015

PLoS ONE

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“…Considering previous study has found the quantitative parameters were less reliable to differentiating PD HCC from WD/MD HCC (18) . Thus, the cut-off values, sensitivity, specificity, and AUC of the five parameters (CERA, CNRhbp, T1RIR, T2RIR and ADC) were then calculated (table 5).…”

Section: Roc Analysismentioning

confidence: 73%

Prediction of histologic differentiation grade of hepatocellular carcinoma by magnetic resonance imaging with hepatospecific contrast agent

Wang

et al. 2021

Int J Radiat Res

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Background: To evaluate the predictive value at the hepatobiliary phase (HBP) magnetic resonance imaging (MRI) after gadobenate dimeglumine (Gd-BOPTA) injection for histologic grades of hepatocellular carcinoma (HCC). Materials and Methods: HCC patients who underwent Gd-BOPTA-enhanced MRI were analyzed and divided into four histologic grades of differentiation based on Edmonson-Steiner grade. Besides, HCC tumor differentiations grade I, II and III, IVwere defined as well-differentiated (WD), moderatelydifferentiated (MD), poorly-differentiated (PD), respectively. The clinical, pathological and imaging features of patients were assessed. Receiver operating characteristic (ROC) curve was to evaluate the significance between WD/MD HCC and PD HCC using the apparent diffusion coefficient (ADC), relative intensity ratio (RIR) of T1WI and T2WI (T1RIR, T2RIR), contrastenhancement ratio in arterial phase (CERA) and contrast-noise-ratio (CNR) in HBP (CNR hbp ). Results: A total of 102 HCC patients were analyzed (grade I, n=19; grade II, n=30; grade III, n=30; grade IV, n=23). There was no statistical difference regarding to the pathological and clinical features among four grades. There were significant differences in CERA, CNR hbp , T1RIR, T2RIR and ADC values among the four HCC grades (all P<0.05). Based on ROC curve, comparison of the five quantitative MRI parameters indicated ADC (sensitivity 84.8%, specificity 82.6%, AUC 0.862) and CNR hbp value (sensitivity 78.5%, specificity 91.3%, AUC 0.916) could significantly distinguish the HCC histological grade. Conclusions: The ADC and/or CNR hbp value in HBP-MRI after GD-BOPTA injection might be as the significant quantitative parameters to distinguish HCC histological grade.

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“…Several studies have additionally shown that qualitative and quantitative examination of the Gd-BOPTA image is of great value in the differential diagnosis of focal liver lesions (29). However, Gd-BOPTA-enhanced MRI has rarely been used to evaluate histological grades of HCC (30)(31)(32), and even less so in the evaluation of small HCC. In this study, the contrast agent used was gadobenate dimeglumine (Gd-BOPTA) which was commonly used in previous reports (15,25,33).…”

Section: Discussionmentioning

confidence: 99%

Quantitative analysis of multiphase magnetic resonance images may assist prediction of histopathological grade of small hepatocellular carcinoma

Weng¹,

Xu²,

Li³

et al. 2020

Ann Transl Med

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Background: The aim of the study was to investigate whether preoperative quantitative analysis of multiphase magnetic resonance images may assist in predicting the pathological grade of small hepatocellular carcinoma (HCC).Methods: A total of 49 patients with small HCCs (≤3 cm) underwent multiphase magnetic resonance imaging (MRI) and were retrospectively reviewed. Routine unenhanced and post gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI were preoperatively performed. Signal intensity (SI) was measured within the designated region of interest (ROI) including those of the lesion and paraspinous muscles. The lesion-toparaspinous muscle relative contrast ratio (RCR) on T2-weighted (T2W) imaging, diffusion-weighted (DW) imaging, and dynamic phase Gd-BOPTA-enhanced T1W (T1-weighted) imaging were calculated, and statistical analysis was performed to determine the predictive power for the histological grade.Results: In all, 49 cases were included comprising 3 well-differentiated (WD) HCCs, 36 moderately differentiated (MD) HCCs, and 10 poorly differentiated (PD) HCCs. There was a negative correlation between the RCR and pathological grade of small HCC in the arterial phase [correlation coefficient (ρ)=−0.305, P<0.05]. However, there was no correlation between RCR in other phases and pathological grade (P>0.05 for all). There was also no correlation between tumor margin, tumor location, cystic/necrotic change, intratumoral fat, enhancement pattern, tumor capsule, tumor boundary or tumor size, and any of the differentiation categories (P>0.05 for all).Conclusions: The lesion-to-paraspinous muscle RCR on arterial phase Gd-BOPTA-enhanced T1W imaging may be useful for the prediction of the histological characteristics of small HCC.

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Does the hepatocellular phase of gadobenate dimeglumine help to differentiate hepatocellular carcinoma in cirrhotic patients according to histological grade?

Cited by 11 publications

References 38 publications

Preoperative Evaluation of the Histological Grade of Hepatocellular Carcinoma with Diffusion-Weighted Imaging: A Meta-Analysis

Preoperative Evaluation of the Histological Grade of Hepatocellular Carcinoma with Diffusion-Weighted Imaging: A Meta-Analysis

Prediction of histologic differentiation grade of hepatocellular carcinoma by magnetic resonance imaging with hepatospecific contrast agent

Quantitative analysis of multiphase magnetic resonance images may assist prediction of histopathological grade of small hepatocellular carcinoma

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